Which are the reasons to perform a lumbar puncture on a child with leukemia? (Select one that does not apply..)

Correct Answer: B

Rationale: A lumbar puncture is done to assess for central nervous system (CNS) involvement and to administer intrathecal chemotherapy. (Ruling out meningitis and staging are not the primary reasons in this context.)

Correct Answer: D

Rationale: Hemophilia is associated with a prolonged PTT due to impaired clotting factor function.

Correct Answer: A

Rationale: Corticosteroids (A) are the mainstay for DBA, with ~70% response rate, unlike androgens (B, less effective), ATG (C, for aplastic anemia), or stem cell transplantation (D, E, reserved for non-responders).

Correct Answer: D

Rationale: Decreased RBC folate (D) directly measures folate stores, the best indicator. Elevated MCV (A) and hypersegmented neutrophils (E) are late signs, low reticulocytes (B) is nonspecific, and high LDH (C) reflects hemolysis, not folate-specific.

Correct Answer: C

Rationale: Splenectomy is indicated for severe HS (A), elliptocytosis (B), thalassemia major (D), and refractory ITP (E). Hereditary stomatocytosis (C) often worsens post-splenectomy due to thrombosis risk, making it an exception.